U.S. patent application number 12/517486 was filed with the patent office on 2010-04-15 for limb support.
This patent application is currently assigned to The Malvern Orthopaedic Company LTD. Invention is credited to Andrew Gardner, Petrus Van Der Walt.
Application Number | 20100089407 12/517486 |
Document ID | / |
Family ID | 37671850 |
Filed Date | 2010-04-15 |
United States Patent
Application |
20100089407 |
Kind Code |
A1 |
Gardner; Andrew ; et
al. |
April 15, 2010 |
LIMB SUPPORT
Abstract
A limb support comprising a first portion for supporting the
lower part of a patient's lower limb, a second portion for
supporting the upper part of the patient's lower limb, each portion
with deep guttering suitable for providing rotational and
angulatory support to the portion of the limb, an adjustable
support, and surface engaging portions comprising the adjustable
support and free end of the second portion.
Inventors: |
Gardner; Andrew;
(Worcestershire, GB) ; Van Der Walt; Petrus;
(Devon, GB) |
Correspondence
Address: |
Husch Blackwell Sanders, LLP;Husch Blackwell Sanders LLP Welsh & Katz
120 S RIVERSIDE PLAZA, 22ND FLOOR
CHICAGO
IL
60606
US
|
Assignee: |
The Malvern Orthopaedic Company
LTD
Malvern
GB
|
Family ID: |
37671850 |
Appl. No.: |
12/517486 |
Filed: |
December 5, 2007 |
PCT Filed: |
December 5, 2007 |
PCT NO: |
PCT/GB2007/004667 |
371 Date: |
December 8, 2009 |
Current U.S.
Class: |
128/845 |
Current CPC
Class: |
A61F 5/3761 20130101;
A61F 5/30 20130101; A61G 7/0755 20130101 |
Class at
Publication: |
128/845 |
International
Class: |
A61G 15/00 20060101
A61G015/00 |
Foreign Application Data
Date |
Code |
Application Number |
Dec 5, 2006 |
GB |
0624228.3 |
Claims
1-31. (canceled)
32. A limb support comprising: a first portion for supporting the
lower part of a patient's lower limb; a second portion for
supporting the upper part of the patient's lower limb; each portion
having deep guttering which provides rotational and angulatory
support to the relevant part of the limb; an adjustable support;
surface engaging portions comprising the adjustable support and
free end of the second portion; a support for supporting the first
portion above a surface, in use; and an adjustable locking hinge
connecting the first and second portions together.
33. A limb support according to claims 32 wherein each of the first
and second portions is open-topped.
34. A limb support according to claim 32 wherein each of the first
and second portions are internally padded
35. A limb support according to claim 32 wherein the portions have
a disposable cover thereon.
36. A limb support according to claim 32 wherein the second portion
is provided internally with side support for the patient's
knee.
37. A limb support according to claim 36 wherein the end of the
second portion remote from its connection to the first portion has
its edge tapered to accommodate the patient's thigh and wherein at
said end, the sides of the second portion are sloped to reduce in
height to said tapered edge.
38. A limb support according to claim 32 wherein the internal
surface of the first portion is longitudinally centrally recessed
to accommodate, in use, the patient's heel.
39. A limb support according to claim 32 wherein at the end of the
first portion adjacent its connection to the second portion, the
sides of the first portion are reduced to accommodate, in use, a
tibial or traction pin in the lower part of the patient's lower
limb.
40. A limb support according to claim 32 wherein the locking hinge
comprises first and second interengaging parts associated with the
first and second portions respectively.
41. A limb support according to claim 32 wherein the locking hinge
comprises first and second interengaging castellated plates,
wherein one of the plates is directly fixed to its associated limb
support portion, whilst the other of the plates is part of an
adjustment bracket or link adjustably connectable with the other of
the limb support portions.
42. A limb support according to claim 41 wherein the bracket or
link can be slidably adjustable relative to the said other of the
limb support portions, and the adjustment is either stepped or
stepless.
43. A limb support according to claim 42 wherein a pair of the said
first and second interengaging parts is provided at each side of
the limb support to connect the first and second parts
together.
44. A limb support according to claim 32 wherein the support for
supporting the first portion above a surface, in use, is in the
form of a stirrup, the opposite free ends of which are connected at
respective opposite external sides of the first portion.
45. A limb support according to claim 32 wherein the stirrup is
carried by a base structure resting, in use, on said surface.
46. A limb support according to claim 45 wherein the base structure
is vertically adjustable.
47. A limb support according to claim 32 wherein the base structure
comprises one of the group of a single vertically adjustable,
upright disposed centrally of the stirrup, or a pair of spaced
uprights disposed symmetrically of the stirrup, wherein each member
of the group is either fixed or vertically adjustable.
48. A limb support according to claim 32 wherein the single
upright, or the pair of uprights may extend to a transverse foot
bar or the like received, in use, on the said surface.
49. A limb support according to claim 33 wherein each of the first
and second portions are contoured to support said lower and upper
parts of the patient's lower limb respectively.
50. A limb support according to claim 34 wherein the padding is
removable so that different thickness can be used for different
sizes of limb, and preferably the padding is disposable.
51. A limb support of claim 46 wherein each connection between a
free end of the stirrup and a side of the first portion of the limb
support is in the form of an adjustable locking hinge of one of the
group comprising interengaging castellated plates, or the same type
connecting the first and second portions of the limb support.
Description
[0001] This invention relates to a lower limb support, which has
particular application to support after lower limb injury or
surgery.
[0002] After lower limb injury or surgery, swelling and deep vein
thrombosis are not infrequent complications. Swelling can
contribute to the development of stiffness, skin breakdown,
infection or compromise of the circulation with potentially
disastrous consequences. Deep vein thrombosis can lead to potential
fatal pulmonary embolism (blood clot to the lung).
[0003] A range of lower extremity injuries often require some days
of elevation before definitive surgery can be safely considered,
due to the nature of the injury or degree of swelling. Effective
elevation after significant lower limb trauma surgery is in most
cases desirable. Rotational and/or angulatory control during this
time is usually helpful. Although most adult and a significant
percentage of paediatric femur fractures are now treated by
surgical stabilisation and not in traction for several weeks as
previously, a percentage of femur and hip injuries and other
conditions, are still treated in traction for a range of reasons.
Elevation with rotational and angulatory control is usually
desirable in such cases.
[0004] Currently used lower limb supports are either rather basic
or excessively complex. The foot end of the patient's bed can be
elevated, but the upper body and head of the patient then usually
also needs elevation, leaving the pelvis, another area well known
for the development of even more serious clots in the larger veins,
as the lowest point, and therefore at risk. The commonest form of
lower limb elevation in most hospitals is still the use of one or
more pillows, since this solution is inexpensive, comfortable and
always available. The use of one or more pillows is however
unstable and unreliable when more than slight elevation is
desirable. Further, it cannot provide rotational or angulatory
support, which is often necessary. A range of foam wedges for
elevation and a foam gutter to control rotation are available.
These are, however, bulky, often not supportive enough to control
rotation or angulation, and not adjustable. Rigid metal frames are
used in many hospitals, but these do not provide rotational or
angulatory support and are usually not adjustable.
[0005] An object of the invention is to provide in an improved
manner a limb support for the elevation thereof.
[0006] According to a first aspect of the invention there is
provided a limb support comprising a first portion for supporting
the lower part of a patient's lower limb, a second portion for
supporting the upper part of the patient's lower limb, a support
for supporting the first portion above a surface, in use, and
adjustable locking hinge means connecting the first and second
portions together.
[0007] Preferably each of the first and second portions is
open-topped, and more preferably they are contoured to support said
lower and upper parts of the patient's lower limb respectively.
[0008] Desirably each of the first and second portions are
internally padded. The padding can be removable so that different
thickness can be used for different sizes of limb, and can thus be
a disposable item. The portions may also have a disposable cover
therein. Conveniently the second portion is provided internally
with side support for the patient's knee. Advantageously the end of
the second portion remote from its connection to the first portion
has its edge tapered to accommodate the patient's thigh. Moreover
at said end, the sides of the second portion are sloped to reduce
in height to said tapered edge.
[0009] In a preferred embodiment the internal surface of the first
portion is longitudinally centrally recessed to accommodate, in
use, the patient's heel. Preferably at the end of the first portion
adjacent its connection to the second portion, the sides of the
first portion are reduced to accommodate, in use, a tibial or
traction pin in the lower part of the patient's lower limb.
[0010] Conveniently the locking hinge means comprise first and
second interengaging parts associated with the first and second
portions respectively. In a preferred embodiment the locking hinge
means comprise first and second interengaging castellated plates.
One of the plates is preferably directly fixed to its associated
limb support portion, whilst the other of the plates is part of an
adjustment bracket or link adjustably connectable with the other of
the limb support portions. The bracket or link can be slidably
adjustable relative to said other of the limb support portions, and
the adjustment could be stepped or alternatively it could be
stepless.
[0011] In the most preferred embodiment, a pair of said first and
second interengaging parts is provided at each side of the limb
support to connect the first and second parts together.
[0012] Advantageously the support for supporting the first portion
above a surface, in use, is in the form of a stirrup, the opposite
free ends of which are connected at respective opposite external
sides of the first portion. In a preferred embodiment the stirrup
is carried by a base structure resting, in use, on said surface.
The base structure can be vertically adjustable, and in a most
preferred embodiment, each connection between a free end of the
stirrup and a side of the first portion of the limb support is in
the form of an adjustable locking hinge, which may be of the type
comprising interengaging castellated plates, i.e. of the same type
connecting the first and second portions of the limb support.
[0013] The base structure may comprise a single vertically
adjustable, upright disposed centrally of the stirrup, or it may
comprise a pair of spaced uprights disposed symmetrically of the
stirrup, each possibly vertically adjustable. The single upright,
or the pair of uprights may extend to a transverse foot bar or the
like received, in use, on said surface.
[0014] According to a second aspect of the present invention, there
is provided a limb support comprising a first portion for
supporting the lower part of a patient's lower limb, a second
portion for supporting the upper part of the patient's lower limb,
the first and second portions being pivotally connected together,
and a base structure having a first part to which the first portion
is pivoted, and a second part to which the second portion is
pivoted, the length of the base structure defined by said first and
second parts being adjustable to alter the degree of
elevation/inclination of at least one of the first and second
portions.
[0015] Preferably each of the first and second portions is
open-topped, and more preferably they are contoured to support said
lower and upper parts of the patient's lower limb respectively. The
end of said first portion remote from said second portion may be
closed.
[0016] Desirably the first and second parts of the base structure
are telescopically slidably adjustable to alter the length of the
base structure and thus the respective elevations/inclinations of
the first and second support portions. In one embodiment the first
part has one or more upstanding arms at or between which is a
crossbar to which said first portion is pivoted. The upstanding arm
or arms can be length adjustable.
[0017] The second part of the base structure advantageously is
slidable within hollow tubes of the first part of the base
structure, and conveniently said second portion is pivoted to a
crossbar of said second part of the base structure. More desirably
locking means are provided for locking the base structure in a
selected adjusted position and for releasing same when adjustment
is required. In one embodiment the adjustment is stepless, but
alternatively the locking means could engage in spaced longitudinal
openings to provide stepped adjustment. The locking means can be
one or more lock nuts, or alternatively one or more over-centre
clamps or levers for a quick lock and release.
[0018] The first and second support portions are preferably
pivotally connected together by a pair of pivots at respective
opposite sides thereof, each pivot preferably being made up of a
part connected to the first portion and a part connected to the
second portion. More preferably each connection is by means of a
link riveted or otherwise secured to the first or second
portion.
[0019] Each of the first and second support portions are preferably
internally padded. The padding can be removable so that different
thicknesses can be used for different sizes of limb, and can thus
be a disposable item.
[0020] Other aspects and features of the invention will be apparent
from the claims.
[0021] The invention will now be described, by way of example, with
reference to the accompanying drawings, in which:
[0022] FIG. 1 is a schematic perspective view of a limb support of
the invention in its partly extended form,
[0023] FIGS. 2 to 4 are side views of the limb support of FIG. 1 in
its fully extended, partly retracted and further retracted forms
respectively,
[0024] FIG. 5 is a view like FIG. 2, of an alternative embodiment
of limb support,
[0025] FIG. 6 is a view like FIG. 2 of a further embodiment of a
limb support,
[0026] FIG. 7 is a view like FIG. 1, of a still further embodiment
of a limb support,
[0027] FIG. 8 is a side view of the embodiment of FIG. 7,
[0028] FIG. 9 is a top plan view of the embodiment of FIG. 7,
[0029] FIG. 10 is an exploded view of the embodiment of FIG. 7,
[0030] FIG. 11 is a schematic perspective view in exploded form of
a further embodiment of a limb support according to the
invention;
[0031] FIG. 12 is a plan view of the embodiment shown in FIG.
11;
[0032] FIG. 13 is a perspective view of the embodiment shown in
FIGS. 11 and 12 with a detail of the hinge mechanism; and
[0033] FIG. 14 is a side view of the embodiment shown in FIGS. 11,
12 and 13.
[0034] The limb support shown in the Figures is principally
intended for providing elevation/inclination, in use, to a
patient's leg, and accordingly hereinafter the support will be
described in relation to its use with a patient's leg, namely both
the upper part above the knee and also the lower part of the leg
beneath the knee down to and including the patient's foot.
[0035] In the embodiment shown in FIGS. 1 to 4, the limb support
basically comprises four components, namely a base structure formed
of a first fixed part 10 and a second adjustably movable part 11,
and a support structure made up of a first support portion 12 for
supporting a patient's foot and lower leg (calf), and a second
support portion 13 for supporting the patient's thigh, i.e. portion
of the patient's leg above the knee.
[0036] Although the base structure of the limb support of the
invention could take various forms, the most important aspect of
the base structure is that its length is adjustable so that, as
will be described, altering its length alters the degree of
elevation/inclination of the first and second support portions of
the limb support.
[0037] In the embodiment shown in FIG. 1, the first fixed part 10
of the base structure comprises a pair of straight hollow metal
tubes 14, 15 respectively which are parallel and spaced apart. At
one end the tubes are connected to a transverse crossbar 16 which
is preferably of solid circular cross-section bar with respective
cushion or rubber feet 17, 18 at the opposite ends thereof. The end
of each tube can be connected to the crossbar 16 in any convenient
manner, for example by welding. At the respective junctions of the
tubes 14, 15 with the crossbar 16, are respective metal arms 19, 20
upstanding at 90.degree. from the plane of the tubes 14, 15. Again
these arms 19, 20 may be secured at said respective junction by any
suitable means, such as welding. The arms, which are thus parallel
to one another and spaced apart by the same spacing as that between
the tubes 14, 15, have a crossbar 21 connected between the
respective upper free ends of the arms 19, 20 and extending from
the junction of the arms 19, 20 and the crossbar 21 at an angle
downwardly onto the respective tubes 14, 15, are respective struts
22, 23 to provide rigidity to this fixed part 10 of the base
structure. At the respective opposite ends of the tubes 14, 15
remote from the crossbar 16, the tubes are screw threaded to
receive respective lock screws 24, 25. As will be described
hereinafter, tightening or loosening of these lock screws secures
or releases the part 11 of the base structure to or from the fixed
part 10.
[0038] The part 11 of the base structure is formed of two parallel
rods 26, 27 respectively which are of a cross-section and a size so
that each can be slidingly received in a respective one of the
tubes 14, 15, with the spacing apart of the rods being such as to
allow this reception of them in the tubes 14, 15 as shown in FIG.
1. At the respective ends of the rods remote from the first fixed
part 10 of the base structure, the rods are secured, for example by
welding, to a transverse crossbar 28 of substantially the same form
as the crossbar 16, the crossbar 28 having feet equivalent to the
feet 17, 18 for the crossbar 16. One foot 29 is shown in FIG. 1.
The feet on the crossbars 16 and 28 are intended to be received on
a surface, in use, on which the limb support rests. Accordingly it
will be understood that the lock screws 24, 25 can be manually
rotated in opposite directions so as to tighten them down onto the
portions of the rods 26, 27 within the tubes 14, 15 thereby locking
the movable part 11 of the base structure relative to the fixed
part 10 and thus fixing the length of the limb support base
structure. If adjustment is required, as will be referred to
hereinbelow, the lock nuts 24, 25 are loosened so that the movable
part 11 can be slid further into the fixed part 10 or alternatively
out of the fixed part 10, so as to shorten or lengthen the length
of the base structure as required, this adjustment therefore taking
place by virtue of the telescopic inter-engagement of the first
part 10 and the movable part 11 of the base structure. It will be
understood from the above that in this embodiment the adjustment is
stepless. It is possible for the engagement of the end of each lock
screw down onto the rod 26 or 27 to be sufficient to lock the
adjusted movable part 11 in place. However alternatively some form
of more positive locking could be provided, and alternatively the
adjustment could be stepped, i.e. the rods 26, 27 could be provided
with longitudinally spaced detents or the like into which the free
ends of the lock screws engage in the locking position.
Alternatively the rods 26, 27 could be replaced by hollow tubes
which are provided with a series of longitudinally spaced apart
openings in which the ends of the lock screws positively engage to
provide the stepped adjustment.
[0039] In an alternative embodiment the lock nuts could be replaced
by over-centre clamps or levers, providing a quick release/locking
arrangement. In a further alternative embodiment the base structure
could have a single telescopic rod and tube arrangement rather than
rods 26, 27 and tubes 14, 15.
[0040] Although in the terms of the invention it would be possible
for each of the support portions 12 and 13 to be basic supports for
the portions of the patient's leg referred to above, for example in
the form of flat boards or the like, the embodiment shown in the
Figures provides each of the support portions in a form which is
both open topped and internally contoured. By providing each
support portion in effect in the form of a padded gutter, it is
possible by making this gutter deep enough, effectively to control
rotation and angulation.
[0041] Accordingly as seen in the embodiment of FIGS. 1 to 4, the
first support portion 12 is of open-topped gutter form with
internal padding denoted generally at 30, so that the inside of the
gutter is contoured to receive therein and support the lower leg
and foot of the patient, i.e. the portion of the patient's leg
below the knee. As shown in the drawing, the end of the portion 12
at which the patient's foot is disposed in use, can be closed as at
31. However, is it preferable that this end is not closed because
it is useful for a Doctor to be able to see a patient's foot at a
glance in order to check for circulatory problems. The padding can
be replaceable, so that different thicknesses can be provided for
different sizes of limb. The padding can thus be a disposable
item.
[0042] It can also be seen from FIGS. 1 to 4 that at the closed end
31 of the first support portion 12, the portion 12 is pivotally
connected to the crossbar 21, this being by any convenient pivoting
means. For example there could be a lower extension to the support
portion 12 through which the crossbar 21 passes so that the support
portion 12 can angularly move up and down on this cross bar 21. As
shown in FIG. 1, the opposite end of the support portion 12 is
open.
[0043] The second support portion 13 is very similar in
construction to the first support portion 12, in that although it
is shorter than the portion 12, and has, at its front, its opposite
sides upwardly curved, it is again of open-topped gutter form with
internal padding as denoted at 32. As shown in the drawings, it is
open at both of its ends. As with support portion 12, the support
portion padding can be replacable and thus disposable.
[0044] At its cut-away front end, the support portion 13 is, at its
underside, pivotally connected to the crossbar 28. The pivotal
connection can be of any convenient form and can, conveniently, be
of the same form as the pivot between the support portion 12 and
the crossbar 21.
[0045] As shown in FIGS. 1 to 4, the respective open ends of the
first and second support portions are generally spaced apart, this
being at the position, in use, which substantially corresponds to
the position of the patient's knee joint. Correspondingly at this
position the first and second support portions are pivotally
connected together by any suitable pivot means.
[0046] In the example shown in the drawings, there are respective
pivotal connections at opposite sides of the spacing between the
two support portions. As can be seen from the drawing, the pivotal
connection between the portions 12 and 13 at each side comprises
respective links 33, 34 secured, for example by riveting, to
respective sides of the support portion 12 and the support portion
13, the respective adjacent ends of the links each carrying a
rotational part of the pivotal connection, these two rotational
parts interlinking and inter-engaging to form a generally circular
pivot as indicated at 35 for one side of the support portions 12
and 13, with the circular pivot 36 being shown at the opposite
side.
[0047] The pivots 35 and 36 allow relative angular movement between
the support portions 12 and 13 as the length of the base structure
of the limb support is varied, and as a result the elevation of
each of the support portions 12 and 13 is similarly adjusted so as
to provide the correct elevation for the patient's leg.
[0048] From the foregoing, it is believed apparent how the device
operates in use. As described, the length of the base can be
adjusted from the fully extended position shown generally in FIG. 2
where the first support portion 12 is in its extreme downwardly
angled position, with the second support portion 13 being, in this
state, substantially in line with the first support portion 12.
This is reflected by the fact that, as shown in FIG. 2, the
respective links 33, 34 associated with the circular pivot 35 are
almost in line. In this position the patient's leg can be supported
almost straight, with the thigh, i.e. the upper part of the leg
above the knee, being received in the second support portion 13 and
the lower part of the patient's leg (calf) and foot being received
in the first support portion 12.
[0049] If however it is desired to alter the elevation/inclination
of the patient's leg, the limb support is adjusted from its FIG. 2
position to for example, its FIG. 3 position by loosening the lock
screws 24, 25 and sliding the part 11 of the base structure
telescopically into the tubes 14, 15 until the FIG. 3 position is
reached, where the length of the base structure is now reduced.
This reduction in the length causes the upward pivoting of the
second support portion 13 and a corresponding upward pivoting of
the first support portion 12, with the results that the upper part
of the patient's leg above the knee is now more elevated, whilst
the lower part of the leg and foot is less angled. When in this
adjusted position, the lock screws 24, 25 can be tightened to
maintain the adjusted state. FIG. 4 shows a further adjusted
position where the length of the base structure has been further
reduced by untightening the lock screws and pushing the movable
part 11 further into the tubes 14, 15 of the fixed part 10. As can
be seen in FIG. 4, this further pivots the second support portion
13 upwardly in an anticlockwise direction, whilst the first support
portion 12 pivots upwardly in a clockwise direction to bring it
more to the horizontal, with the result that the elevation of the
patient's upper leg part is increased still further.
[0050] Accordingly the limb support provided is in the form of a
light-weight frame designed for the effective and comfortable
support of a patient's leg in adjustable gradients of elevation. As
stated, the lower leg and foot is supported in a padded gutter,
which is deep enough effectively to control rotation and
angulation. The adjustable hinge at knee level makes it possible to
support the leg with the knee in variable degrees of flexion or in
full extension. The support can be used in conjunction with a range
of skin or skeletal traction options.
[0051] In an alternative form of limb support, shown in FIG. 5,
each arm 19, 20 is height adjustable. With the embodiment of FIGS.
1 to 4, adjustment of the angle between the thigh and calf parts by
sliding rods 26, 27 in and out of tubes 14, 15 results in the
gradient of the calf or thigh changing, whilst the height of the
foot from the base structure remains constant. If the leg is held
straight as in FIG. 2, there is a fixed gradient, as arms 19 and 20
are not adjustable. To be able to alter the height of the foot
relative to the base structure, the arms 19, 20 are shown
adjustable in FIG. 5.
[0052] Here the upper parts of arms 19, 20 are still connected to
the crossbar 21, but their respective lower parts are
telescopically slidable in respective hollow tubes upstanding from
the transverse crossbar 16, with locknuts or over-centre clamps or
levers to lock the arms in a height adjusted position. In FIG. 5,
there is shown a hollow lower tube 19a in which the arm 19 can
slide, and a lock nut 19b. The struts 22, 23 now extend from the
tubes 14, 15 to the tops of the upstanding tubes 19a
respectively.
[0053] A different form of adjustable lower limb support is shown
in FIG. 6. The main difference from the forms shown in FIGS. 1 to 4
and FIG. 5 respectively is that the pivots 35 and 36 are replaced
by respective locking hinges, one of which 35a is shown, the hinges
preferably being of a type manufactured by Sciel GmbH of Germany.
By depressing a spring loaded button of the hinge the lock provided
by interengaging teeth is released, allowing relative angular
adjustment between the arms of the hinge, and thus between the
first and second support portions 12 and 13 respectively. When the
adjustment is complete, the button is released, and the hinge is
locked, thereby fixing the portions 12 and 13 in a relatively
adjusted chosen position.
[0054] The base structure is accordingly modified, comprising
merely a first part to support the first support portion 12 and a
separate, second part 29a to support the second support portion 13.
Thus when the portions 12 and 13 are relatively adjusted as
described, the two unconnected supports forming the base structure
are merely moved relatively towards or away from one another
appropriately.
[0055] As with the FIG. 5 embodiment, the support for portion 12
can be height adjustable, and preferably it is in the form of a
tripod.
[0056] The connection at the crossbar to the portion 12 may also be
by means of a locking hinge 37 or locking hinges, which could be
set at a fixed position. The locking hinges 35a and 37 are shown as
part of the limb support, and also separately to an enlarged scale,
in FIG. 6. The support for portion 12 may be foldable about the
hinge 37.
[0057] FIGS. 7 to 10 show a preferred form of a limb support of the
invention. It comprises a first support portion 38 and a second
support portion 39, having respective support functions equivalent
to the portions 12 and 13 of the first three embodiments. However
the first and second support portions of this embodiment are
refined as compared to portions 12 and 13, in relation to improving
support of the patient's leg.
[0058] Firstly, the second portion 39 is provided adjacent its end
nearest the first portion with opposite internal side supports for
the patients knee, one of which supports 40 is shown in FIG. 7.
Secondly, the broader free end of the second portion has its edge
tapered, as at 41, to accommodate the patient's thigh. Moreover at
said end, the sides of the second portion are sloped down to reduce
in height towards said tapered edge. It will be noted from FIG. 7
that there is no base support associated with the second portion,
namely the underside of the free end thereof is intended to rest,
in use, directly on the surface on which the limb support is
positioned.
[0059] Thirdly, the first portion 38, adjacent its end furthest
from the second portion, is centrally internally recessed as at 42
in FIG. 9, to accommodate, in use, the patient's heel. Fourthly,
the end of the first portion 38 adjacent the heel recess 42 is open
to allow a Doctor to easily see the patent's foot. Fifthly, the
first portion 38, at its end adjacent its connection to the second
portion, has its opposite sides reduced in height in order to
accommodate, in use, a tibial or traction pin in the lower part of
a patient's lower limb, i.e. at a position just below the knee.
Sixthly, foam inserts 38a and 39a, as shown in FIG. 10, are
provided to cushion the first and second portions 38, 39,
respectively. These inserts 38a, 39a may be provided in a variety
of sizes to suit different sized patients, for example, they may be
4 mm, 8 mm or 12 mm thick and may be made from polyethylene
foam.
[0060] It is to be understood that appropriate ones of the
refinements mentioned in respect of support portions 38 and 39 may
be incorporated into the support portions 12 and 13 of the
embodiments of FIGS. 1 to 4, FIG. 5, and FIG. 6, respectively.
[0061] Next with regard to the embodiment of FIGS. 7 to 10, it will
be noted that the connection between the first and second support
portions is different from that in the first two embodiments. FIG.
10 shows that adjustable locking hinge means at each side of each
of the limb supports comprise first and second interengaging parts
associated with the first and second support portions 38, 39
respectively. These interengaging parts comprise first and second
interengaging castellated plates 43, 44 respectively. These are
configured to allow angular adjustment in 20.degree. increments. In
the example shown, the plate 44 is secured to the exterior surface
of the second support portion 39 at its narrower end, i.e. the end
opposite that at which its edge is tapered.
[0062] The plate 43 is, in this example, part of an adjustment
bracket or link 45 connectible with the first support portion 38 to
vary the distance between the first and second support portions 38,
39, as well as allowing for hinging between the two parts to alter
the inclinations thereof. As shown in FIGS. 7, 8 and 10 the plate
43, which is at one end of the link 45, is of circular form, the
remainder of the link 45 being straight and extending generally
radially from the plate. This remainder of the link 45 is provided
with longitudinally aligned spaced apertures selectively engageable
with a peg on the exterior of the side of said first portion 38 to
space apart the two support portions 38 and 39 as required. The
exterior of the side of the first portion may be recessed to
accommodate the link 45.
[0063] Various alternatives are possible. Firstly the plate 44
could also be part of a link 45 instead of, or in addition to,
plate 43. Thus, either or both of the first or second portions 38,
39 may include adjustment means such as an adjustable link 45 to
vary the separation of the two support portions 38, 39.
Alternatively plate 43 need not be part of an adjustable link.
Secondly, instead of being stepped, the adjustment could be
stepless. Thirdly, locking means other than castellated plates
could be used.
[0064] A pair of locking hinge means is preferably provided at
respective opposite sides of the limb support (FIG. 9) to connect
the first and second support portions together, but only the pair
at one side is shown in FIGS. 7, 8 and 10.
[0065] Whereas the end support for the first portion 12 in the
first three embodiments comprises a pair of spaced uprights, which
may or may not be height adjustable, and on which the first portion
is hinged, FIG. 7 shows a single support in the form of stirrup 46
carried by a base structure formed by a single central upright
tube/column 47 fixed to a transverse foot bar 48, equivalent to
crossbar 16. As shown, the upright 47 can be height adjustable, in
a similar manner to arm 19 in tube 19a with lock nut 19b
therebetween. However, as shown in this example, an e-clip 47a is
provided to lock the height of the upright 47.
[0066] As shown in FIG. 7 the transverse foot bar 48 may be
extendible by means of respective rods 48a telescopically engaged
in each end of the bar 48. Extending the foot bar 48 increases the
stability of the support. Knurled end caps 48b are attached to the
respective free ends of the rods 48a to provide grip.
[0067] The stirrup 46 cradles the underside of the first support
portion 38, and extends along opposite sides thereof. Its opposite
free ends are connected to respective external sides of the first
support portion 38 by means of respective adjustable locking
hinges, which may, as shown, be of the type described in relation
to plates 43, 44, namely utilising interengaging castellations.
Thus one part of the locking hinge is fixed to the outside of the
first support portion 38, whilst the other part is fixed to a free
end of the stirrup 46. The first support portion 38 can thus be
pivoted relative to the upright 47.
[0068] Instead of a single upright, there may be a pair of spaced
uprights disposed symmetrically of the stirrup 46, each upright
possibly being vertically adjustable.
[0069] Referring to FIGS. 11 to 14 there is shown a leg support 50
according to the invention comprising a first support portion 52,
and a second support portion 54. (substantially equivalent to
support portions 12 and 38, and 13 and 39 respectively in the
earlier embodiments). The limb support further comprises a height
adjuster 56. In this embodiment, preferably height adjuster 56
comes in two or more fixed heights and are therefore
interchangeable in order to set the position of first support
portion 52 above a surface (such as a bed).
[0070] In one form the first and second support portions are
manufactured using rotational moulds for example using medium
density polyetholeyne (MDPE). Beneficially, the material can
comprise an anti-bacterial impregnation such as an active silver
ingredient for example from Microban (registered trade mark) or
Biocote (registered trade mark). In other forms, the first and
second support portions are manufactured via thermo forming or
thermostat formula processes, again, preferably comprising
anti-bacterial impregnation.
[0071] Height adjuster 56 comprises a transversely extending foot
portion 58, a vertical post 60 and a connecting portion 62 for
connection to the first support portion 52 preferably at a hinge
64. Hinge 64 is most preferably a locking hinge similar to hinge 44
in FIG. 10. In an embodiment, connection portion 62 is U shaped and
sized to accommodate the first support portion 52 and to connect
thereto via two hinges 64 on each side of the first support portion
52 as can be seen in FIG. 12 for example.
[0072] As can be seen in FIG. 11, two or more height adjusters 56
are preferably provided for a limb support 50 and here a first
height adjuster 56a has a vertical post 60 approximately four times
the length of post 60 on the second height adjuster 56b. For
example, the height of post 60 of height adjuster 56a might be in
the order of 10 to 20 cm and preferably in the order of 15 cm. The
height of post 60 in embodiment 56b, might be in the order of 2 to
10 cm and preferably in the order of 6 cm. As can be seen, a
patient's ankle sits fairly proximal the upper end of post 60 being
separated only by the thickness of padding 66 the thickness of
first limb support portion 52 and a small gap above the upper end
of post 60.
[0073] Referring to FIG. 11, it can be seen that insertable padding
portions 66 and 68 are provided. Preferably the padding inserts 66
and 68 are suitably shaped and contoured to nest well on the inside
of first and second support portions 52 and 54 respectively.
Beneficially the insertable padding 66 and 68 are disposable and
can come in sizes to suit different types of patients, thereby
incorporating thicker padding for thinner legs and thinner padding
for larger legs.
[0074] Accordingly limb support 50 can come as a set of parts,
comprising hinged first support portion 52 and second support
portion 54 together with a range of height adjusters 56 and a
selection of insertable padding 56 and 68.
[0075] As in earlier embodiments, first support portion 52 and
second support portion 54 are preferably hinged together to allow
adjustment of the relative angle of the portions to one another.
Referring to FIG. 13, an enlarged view of hinge 70 is shown.
Preferably the hinge 70 comprises a first arm 72 attachable to
first support portion 52 (recessed and attached eg screwed as in an
earlier embodiment), and a second arm 74 attachable (in a recess
and screwed or suitably fixed) to second support portion 54.
Preferably the hinge comprises a central pivot 76 and also
predetermined angle selector 78. In one form, arm 72 can comprise
two or more tapped apertures adjacent to hinge 76 which enable a
screw 82 to be inserted via a slot 80 enabling a patient carer,
such as a nurse, to adjust the relative angle of first and second
portions 52 and 54 by selecting the aperture in arm 72 fixing screw
82 into the selected tapped hole on each side of limb support 50
thereby rigidly to hold the first and second limb supports 52 and
54 at the selected angle. Beneficially, the screw 82 of the angle
selector 78 is configured so as not to be removable from slot 80.
In a preferred form, the tapped apertures in arm 72 are selected to
enable the angle of inclination of first and second support
portions 52 and 54 to be 0, 15.degree. and 30.degree..
[0076] Accordingly, in use limb support 50 is configured from a set
of parts to provide suitable lower limb support for a patient. To
configure limb support 50, a carer needs to select suitable
disposable insert 66 and 68 of appropriate dimensions for the
predetermined patient. Additionally, the carer needs to select the
height of elevation, based on clinical determination, and select
from a choice of height adjusters 56. Additionally, the carer needs
to select the relative angle of the first and second support
portions 52 and 54 by adjusting the adjustment mechanism 78.
Accordingly, in use the limb support 50 engages a surface by the
foot 78 of height adjuster 56 and the lower edge 87 of second
support system 54. The configuration of limb support 50 is
determined by the angle selected by the carer at adjuster 58 and
the selected height adjuster 56.
[0077] Beneficially, a stable limb support 50 is provided due to
the length of foot 58 extending laterally from post 60 in the
vertical height adjuster 56. Preferably, the width of the foot 58
at least the width of first leg support 52 on each side of the limb
support 50, as can be seen in FIG. 12 for example. Accordingly, in
one form the foot 58 has an overall width of approximately 50 cm.
Moreover, beneficially a patient's leg is comfortably held by
insertable padding 66 and 68 but nevertheless allows some movement
of the limb within limb support 50. Such movement of a patient is
accordingly stably supported by limb support 50 due to the
configuration of foot 58 and the first and second support portions
52 and 54 respectively, in combination with other components of the
limb support 50 described above. Moreover, the absence of the
horizontal adjustment mechanism of the first embodiment shown in
FIG. 1 for example above provides fewer components, and hence less
complication in setting the limb support 50.
[0078] Although distinct embodiments have been described, it is to
be understood that appropriate features from any one embodiment may
be incorporated into another embodiment as required.
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